An audit of a decade of acute peritoneal dialysis in children with acute kidney injury: A single-center experience.

BACKGROUND

Acute peritoneal dialysis (PD) is the modality of choice to manage children with acute kidney injury (AKI). However, its use remains underutilized, despite the unquestionable advantages.

AIMS

This study, therefore, aimed to audit the complications, outcomes, and challenges encountered with PD as well as indications for PD and causes of AKI among under-5 children that had PD in a Nigerian tertiary hospital over a decade.

. PATIENTS AND METHODS: : A retrospective study of children with AKI, aged 0 to 5 years, managed with PD. In all the children, a PD catheter was inserted at the bedside by surgeons. PD was performed manually. Data were presented in descriptive statistics and a P value <0.05 was considered significant.

RESULTS

Twenty-nine (29) children had PD over a decade (January 2009 to December 2018). There were 12 males and 17 females aged 4-60 months (mean ± SD 18.8 ± 16.9). The PD yearly frequency was 2-7 times/year, mean of 2.9/year. The major identified indication for PD was difficulty of vascular access (86.2%) while the causes of AKI were sepsis 21 (43.8%); gastroenteritis 11 (22.9%); severe malaria 9 (18.8%); toxins/herbal medications 5 (10.4%); multiple congenital anomalies 2 (4.2%). Multiple causes of AKI occurred in some children. The major observed PD complications were catheter lockage 9 (37.5%); dialysate fluid retention 4 (16.7%); and peritonitis 4 (16.7%). The short-term outcome of the 29 children that had PD showed 20 (69%) discharged and 9 (31%) deaths over the period. The major challenge encountered was PD-related sepsis evidenced by the prevalence of peritonitis and catheter site infection.

CONCLUSION

The predominant PD complications were catheter-related, mostly catheter blockage in a manually performed PD while the leading cause of AKI in our center was sepsis, affecting a large population of children requiring PD.